title: Fluid status in peritoneal dialysis patients: the European Body Composition Monitoring (EuroBCM) study cohort.
abstract: BACKGROUND
  Euvolemia is an important adequacy parameter in peritoneal dialysis (PD) patients. However, accurate tools to evaluate volume status in clinical practice and data on volume status in PD patients as compared to healthy population, and the associated factors, have not been available so far.
  
  
  METHODS
  We used a bio-impedance spectroscopy device, the Body Composition Monitor (BCM) to assess volume status in a cross-sectional cohort of prevalent PD patients in different European countries. The results were compared to an age and gender matched healthy population.
  
  
  RESULTS
  Only 40% out of 639 patients from 28 centres in 6 countries were normovolemic. Severe fluid overload was present in 25.2%. There was a wide scatter in the relation between blood pressure and volume status. In a multivariate analysis in the subgroup of patients from countries with unrestricted availability of all PD modalities and fluid types, older age, male gender, lower serum albumin, lower BMI, diabetes, higher systolic blood pressure, and use of at least one exchange per day with the highest hypertonic glucose were associated with higher relative tissue hydration. Neither urinary output nor ultrafiltration, PD fluid type or PD modality were retained in the model (total R² of the model = 0.57).
  
  
  CONCLUSIONS
  The EuroBCM study demonstrates some interesting issues regarding volume status in PD. As in HD patients, hypervolemia is a frequent condition in PD patients and blood pressure can be a misleading clinical tool to evaluate volume status. To monitor fluid balance, not only fluid output but also dietary input should be considered. Close monitoring of volume status, a correct dialysis prescription adapted to the needs of the patient and dietary measures seem to be warranted to avoid hypervolemia.
authors.affiliation: University Hospital Ghent, Ghent, Belgium.
authors.forename: Wim
authors.initials: W
authors.lastname: Van Biesen
authors.forename: John D
authors.initials: JD
authors.lastname: Williams
authors.forename: Adrian C
authors.initials: AC
authors.lastname: Covic
authors.forename: Stanley
authors.initials: S
authors.lastname: Fan
authors.forename: Kathleen
authors.initials: K
authors.lastname: Claes
authors.forename: Monika
authors.initials: M
authors.lastname: Lichodziejewska-Niemierko
authors.forename: Christian
authors.initials: C
authors.lastname: Verger
authors.forename: Jurg
authors.initials: J
authors.lastname: Steiger
authors.forename: Volker
authors.initials: V
authors.lastname: Schoder
authors.forename: Peter
authors.initials: P
authors.lastname: Wabel
authors.forename: Adelheid
authors.initials: A
authors.lastname: Gauly
authors.forename: Rainer
authors.initials: R
authors.lastname: Himmele
mesh_terms: D000328:Adult; D000368:Aged; D001823:Body Composition / Q000502:physiology*; D001826:Body Fluids / Q000378:metabolism* / Q000502:physiology; D016022:Case-Control Studies; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D058266:Dielectric Spectroscopy / Q000295:instrumentation; D005060:Europe; D005260:Female; D006304:Health Status; D006801:Humans; D007676:Kidney Failure, Chronic / Q000378:metabolism / Q000503:physiopathology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000295:instrumentation / Q000379:methods*; D010530:Peritoneal Dialysis / Q000009:adverse effects; D014882:Water-Electrolyte Balance / Q000502:physiology*